EA026018B1 - Dialysis supply system - Google Patents

Abstract

The invention relates to a dialysis supply system having at least one central production unit which enables the dialysis liquid to be prepared and/or to be produced, at least one conducting means which enables said dialysis fluid to be conveyed, and at least one connection means which enables said dialysis treatment unit to be connected.

Description

FIELD OF THE INVENTION

The proposed invention relates to a system for providing a dialysis treatment process with at least one central manufacturing device with which dialysis fluid can be prepared and / or made with at least one conduit through which dialysis fluid can be conducted, and with at least one connecting means by which the unit for the implementation of the dialysis treatment process can be attached.

State of the art

In some dialysis treatment center equipment systems, central dialysis treatment process support systems for preparing dialysis fluid or dialysis fluid concentrates are built-in. Liquids or liquid concentrates, manufactured in a centralized manner, are transmitted through a conductive process support system to individual treatment stations, for example, to stationary treatment units with a monitor for carrying out the dialysis treatment process. In stationary medical units, dialysis fluid is used to clean the extracorporeal blood circulation circulating in the system. Alternatively, the liquid concentrate supplied through the process support system is used for manufacturing on a stationary treatment unit using other components of the solution and diluting agents, ready for use in the dialysis treatment process of the dialysis fluid and supplying it for the dialysis treatment process. The dialysis fluid used after the dialysis treatment process is discharged through the return pipe system of the supply loop system and can be discharged, for example, in a centralized manner. The used dialysis fluid can, however, be supplied directly to the diversion system.

Due to the use of centralized systems that work with dialysis fluid or with liquid concentrate, there is no need to use stationary treatment units (so-called bedside monitors) in dialysis machines that are essential for the operation of commercially available dialysis machines for dialysate manufacture. The central station for providing the dialysis treatment process can supply the previously mentioned dialysate to the stationary treatment unit, so there is no need to use tempering devices or to create such devices with reduced power. You can also abandon the degassers in the dialysis apparatus, since this function can already be taken over by the central process support device.

The installation of bedside monitor systems in dialysis treatment centers sets forth the requirements for regular disinfection of dialysis treatment process support systems and individual inpatient treatment units. In the case of a faulty bedside monitor or stationary treatment unit, for example, various kinds of bacterial contaminants can get into the piping system and spread through it. To ensure safety, accurate disinfection programs must be followed that prevent bacterial contamination of the entire dialysis treatment system. Depending on the size and type of construction of the piping system, this disinfection process can take a sufficient amount of time and, in addition, entail significant costs.

IE 4203905 A2 describes a device for centrally providing inpatient treatment units with dialysate concentrate. To prevent the risk of bacterial infection of the centralized dialysate tank, in this case, a sterilizing filter is connected between the dialysate block and the ring pipe support system.

In I8 2010/0181235 A1, the problem of bacterial reverse infection of centralized systems to support the dialysis treatment process is considered. In this case, a buffer tank is provided that prevents the backflow of bacterial contaminated fluid back into the dialysis treatment support system. Additionally, ultrafilters may be provided in the fluid circulation system from the dialysate side of the inpatient treatment unit.

From EP 0436855 A1, a method for disinfection of a stationary unit for dialysis treatment and a ring pipe system for providing a stationary unit for dialysis treatment with fresh water is known. In this case, the dialysis apparatus is disconnected from the fresh water supply system by means of a valve system, and due to heating or chemical additives, the dialysis apparatus is disinfected, which is also carried out in the circulation mode.

Disclosure of invention

Thus, the object of the present invention is to further improve the system for providing the dialysis treatment process of the previously indicated type, in particular with respect to making it simpler, more reliable and hygienic during operation, and further the disinfection and / or prevention procedure could be simplified. bacterial infection of the piping system through a bedside inpatient treatment unit.

This problem is solved in accordance with the invention by means of a system for providing the dialysis treatment process with the features of claim 1. It is further provided that the dialysis treatment process support system is provided with at least one central manufacturing device, with

- 1 026018 by means of which, directly and / or indirectly, a dialysis fluid can be prepared and / or made by at least one pipeline, through which the dialysis fluid can be carried out by at least one unit for carrying out the dialysis treatment process, and at least one connecting means by which the unit for carrying out the dialysis treatment process can be directly and / or indirectly connected to the pipeline, and also provided with at least with a single valve, preferably a valve system, by means of which the supply to the unit for carrying out the dialysis treatment process and / or the removal of the dialysis liquid, washing, cleaning and / or disinfecting liquids from it in various operating conditions of the dialysis treatment process and / or the disinfection of the installation can be adjusted and / or adjusted, in particular in cooperation with the control and adjustment unit or by means of the control and / or adjustment unit, moreover, as a means for guiding, the transport At least one hydraulics module is provided for calibrating, processing, mixing and / or balancing the dialysis fluid in the unit for performing the dialysis treatment process, the hydraulics module being implemented as a disposable module or as a disposable module.

The hydraulics module may be an ultrafiltration module.

The dialysis treatment process support system may be a central dialysis treatment process system, for example, a hospital dialysis treatment process system, or a hospital inpatient treatment unit, or a dialysis treatment center with a central manufacturing device for preparing dialysis fluid.

In principle, it is possible that parts of the dialysis treatment support system are stationary. So, for example, it can be provided that the central manufacturing device for preparing dialysis fluid is stationary and in the center of the building, for example, a dialysis treatment center or a dialysis treatment station, while devices for implementing the dialysis treatment process can, in principle, be implemented in in the form of mobile units, in the preferred embodiment, in the form of mobile and mobile medical monitors.

The term dialysis fluid or dialysate should not be understood in this case in a limited way, it includes, in particular, not only ready-to-use dialysis solutions, but also dialysate concentrates or dialysate solutions, which must also be provided with additional additives, for example, directly at the place of treatment. So, for example, the dialysate-conducting conduit may be a conduit that conducts ready-to-use dialysate solutions, but also a conduit that conducts the ingredients of the dialysate solution, such as dialysate concentrate.

The conduit may be, for example, a central annular conduit through which dialysis fluid can be prepared and moved. By means of a connecting means, the blocks for carrying out the dialysis treatment process can be directly and / or indirectly connected to the pipeline. The connecting means may be provided for this with appropriate sealing means and / or connecting means or may be in connection with them. It may also be provided that the connecting means is provided with a valve, for example a valve or valve of a valve system, by which the supply of dialysis fluid to the block for the dialysis treatment process can be blocked and / or released.

The valve, by means of which the supply to the unit for the implementation of the dialysis treatment process and / or the removal of dialysis fluid, flushing, cleaning and / or disinfecting liquids from it in various operating conditions of the dialysis treatment process and / or the disinfection of the unit can be adjusted and controlled and / or controlled in conjunction with a control and / or adjustment unit or by means of a control and / or adjustment unit. In this case, we can talk about a decentralized control and / or adjustment unit, for example, a control and / or adjustment device located in the unit for carrying out the dialysis treatment process. In the same way, this can be a centralized control unit and / or adjustment of the dialysis treatment process support system.

In a preferred embodiment, thus, after the end of the treatment procedure, there is no need to clean the dialysis apparatus, since all bacterially contaminated parts can be removed. The likelihood of reverse bacterial infection of the annular pipeline and the central station for providing the dialysis treatment process is also minimized, since due to the removal of disposable elements / elements, it is not possible to continue the bacterial infection of a large number of blocks to carry out the dialysis treatment process, as is the case, for example, in known dialysis machines from the prior art.

It may further be provided that there is at least one hydraulics module as the only means for guiding, transporting, processing, mixing and / or balancing the dialysis fluid in the unit for carrying out the dialysis treatment process.

It is further possible that as a means for directing, transporting and / or treating blood

- 2 026018 in the unit for carrying out the dialysis treatment process, at least one blood module is provided, and that the blood module is implemented as a disposable module or in the form of a disposable module.

In particular, an advantage is revealed that, due to the use of disposable hydraulic modules, the use of a disposable element is possible both on the blood side and on the dialysate side. This allows you to quickly and easily replace the patient, since the disinfection process can be greatly facilitated and simplified, since most bacterially contaminated supplies are used only once. Since materials that are in contact with potentially infectious material from the side of the medical device are disposed of after the treatment procedure, the central dialysate pipe or ring pipe should also be disinfected. The main source of microorganism growth in the dialysate conduit is the fluid-filled conduit itself, not the patient. Thus, the disinfection procedure should be performed much less frequently than changing the patient. Thanks to this, time and money can be saved. For this, automatic disinfection of annular pipelines can be used.

The transition of the patient’s microorganisms to the dialysate conduit or to the ring conduit system is minimized only due to the flow direction. Filters between the supply line and the blood line protect the patient, in the first place, from the passage of microorganisms and endotoxins, i.e. toxins producing microorganisms, from the dialysate conduit to the blood. Used and, thus, potentially bacterially infected dialysate is disposed of in a second pipeline not indicated in the previous figures.

All possible embodiments of the invention are united by the fact that at least one separation membrane or filter is provided between the dialysate and the blood, by which the passage of microorganisms and endotoxins to the patient can be prevented. By means of a second separation membrane or a second filter, a possible failure of the first filter or the first separation membrane can be compensated, which could occur, for example, when the first filter ruptures. If we are talking about simple hemodialysis treatment, in which the exchange of material between blood and dialysate occurs only through the dialysate membrane, that is, through the filter, then, in the preferred embodiment, it may be sufficient to use only one ultrafilter. During hemodialysis filtration treatment, a part of the exchange volume is supplied directly to the blood, and this supplied amount of liquid is again removed through the dialyzer during the exchange process. As a result, on the basis of this, the necessity of using a second filter is revealed, which filters the dialysate directly supplied to the blood before it is supplied to the blood.

Two-stage dialysate filtration is also necessary when using the so-called priming method online. In this case, before starting dialysis treatment, the blood-conducting part of the disposable element is washed with washing liquid. Dialysate is suitable as flushing fluid. In conventional priming methods, the blood-conducting part of the extracorporeal circulation system is connected to a dialysate source and a pumping means, so that it can be washed. When priming online, the flushing fluid, for example, dialysate, is pumped through the blood processing filter into the blood-conducting part of the extracorporeal circulation system using the appropriate pumping means and valve system. Then the blood-conducting part of the extracorporeal circulatory system is washed. By filtering through a blood processing filter, the blood-conducting part of the extracorporeal circulation system is already protected from bacterial contamination. However, for reliability, it is always necessary to go through two stages of filtration, if the liquid must pass into the blood-conducting part. Therefore, against the course of the location of the blood processing filter in the dialysate-conducting part, when priming online, the next filtration step is established.

If all of the circular circuits for conducting the fluid of the unit for carrying out the dialysis treatment process are implemented as disposable elements, then a simple and reliable dialysis treatment process can be provided. Further, as an advantage, the fact is revealed that the frequency of dialysis treatment procedures increases and, accordingly, the time between procedures can be reduced, since in this case you can refuse the cleaning and / or disinfection procedure. Instead, it will be updated with a hydraulics module and other tube set elements that are sterile and ready to use.

It may further be provided that there is at least one filter to prevent reverse bacterial contamination and / or to filter dialysis fluid.

It is further possible that at least one filter is a reusable filter, which is in the direction of dialysate flow opposed to the direction of the hydraulic module and blood module.

Preferably, the at least one filter is a disposable filter.

It is further possible that at least one filter is an integral part of the hydraulic module

- 3 026018 and / or blood module.

In addition, it may be provided that there are at least one first filter and at least one second filter.

It is possible that at least one first filter is a reusable filter, which is located in the direction of the dialysate flow against the direction of the location of the hydraulic module and the blood module.

In a preferred embodiment, the at least one first filter is a disposable filter.

In a preferred embodiment, it may further be provided that the at least one second filter is a disposable filter.

It is possible that at least one second filter is part of a hydraulic module and / or blood module.

Further, it can be provided that both the hydraulics module and the blood module respectively have a filter, which is an integral part of the hydraulics module and / or blood module.

In addition, it is possible that the filter is an ultrafilter, in particular an ultrafilter in the form of a hollow fiber filter, wherein the filter membrane preferably has an average pore size of about 0.1-0.5 microns, in a particularly preferred embodiment, the average pore size of about 0.2 microns.

In addition, it can be provided that at least three dialysate conductive pipelines flow from at least one conduit through which the dialysate fluid can be conducted, and that the valve system has at least three valves, and accordingly one valve is located in the conductive dialysate piping, through which dialysate can be supplied to the unit for the implementation of the dialysis treatment process.

Conducting dialysate pipelines can be understood as pipelines to which a unit can be connected to carry out the dialysis treatment process and through which dialysis fluid can be conducted, and in the disinfection mode, a disinfectant liquid.

It is further possible that two dialysate conductive conduits on the first side of the filter are connected and / or may be connected to the first filter chamber, the first filter chamber being separated from the second filter chamber by the filter membrane, and the third dialysate conduit conduit on the second filter side being connected and / or can be attached to the second filter chamber, so that by the next third pipeline both of the first pipes can be bypassed, or that the third pipe forms a bypass pipe water to both first pipelines.

It is further possible that at least three valves create a valve device, and by means of a control and / or adjustment unit, the valve device can be actuated and / or turned on in such a way that, with the valve device, the filter can be sanitized on one or both sides and / or through a filter membrane.

It may further be provided that by means of a control and / or adjustment unit, the valve device can be actuated and / or turned on in such a way that, with the valve device, the filter can be alternately sanitized on both sides of the filter membrane and a disinfectant liquid can be passed through it. .

In addition, it is possible that in the first mode, the first valve of two valves located in the dialysate-conducting pipelines, which are made with the possibility of connection or attached on the first side of the filter, can be moved to the open position, while the second valve of two valves closed or configured to close, and a third valve located in the next third dialysate conductive conduit, which is configured to connect or attached to the second side of the filter, can be closed or closed, and that in the second mode, the first valve of two valves is made to be closed or closed, while the second valve of two valves is arranged to open, and that the third valve is configured to open position.

It may further be provided that the unit for carrying out the dialysis treatment process is configured to separate, by at least one fourth valve, from at least one dialysate-conducting conduit that conducts the dialysis fluid or through which the dialysis fluid can be conducted.

Further, it is possible that the fourth valve is located upstream of the hydraulic module and along the filter in the connected and / or adapted to connect on the second side of the filter conduit dialysate, and moreover, the filter is located between at least two valves of the valve device, and in a preferred variant two valves are located on the first side of the filter, and two valves are located on the second side of the filter.

The first side of the filter may be the side that faces away from the hydraulics module, that is, the dialysate must still pass through the filter membrane in order to reach the hydraulics module. The second side of the filter is the side facing the hydraulic module, respectively. As a result, an advantage is revealed that the third pipeline is a pipeline that can be used in a disinfection mode. So, for example, the first mode can be a normal mode of the treatment process, with the first pipeline designed to supply dialysate, and the second and third pipelines blocked by valves located on them. In the second mode, which is a cleaning and / or disinfection mode, the first pipe is closed by means of a valve located on it, and in a preferred embodiment, the connecting pipe, by which the unit for carrying out the dialysis treatment process is connected to the pipe, is blocked by a fourth valve. The second and third pipelines open in this mode, so that the filter can flow around on both sides of the membrane. As a result, particularly preferred cleaning and / or disinfection is possible, and the filter can be implemented without problems in the form of a reusable filter. Valves can be adjusted, for example, by means of a control unit and / or pipe adjustment. This control and / or adjustment unit may be a central control unit and / or pipe adjustment.

The proposed invention further relates to a hydraulics module with the features of claim 22. Then it is provided that the hydraulics module refers to a unit for carrying out the dialysis treatment process in the system for providing the dialysis treatment process according to one of claims 1 to 21 of the claims with the features of the hydraulics module according to one of claims 1 to 21.

The proposed invention further relates to a disposable tube set with the features of claim 23 of the claims. It is then provided that the disposable tube set includes at least one hydraulics module, the hydraulics module having the features of a hydraulics module according to one of claims 1 to 22 of the claims, and in a preferred embodiment, the blood module is also integrated into the tubing set.

A set of tubes is provided in a preferred embodiment for use in a unit for carrying out a dialysis treatment process, and in a preferred embodiment of the invention, it is a block for carrying out a dialysis treatment process for a system for providing a dialysis treatment process in accordance with claims 1 to 21. In a preferred embodiment, the unit for carrying out the dialysis treatment process is provided with corresponding clamping elements to which a set of tubes can be connected by means of corresponding mating parts.

In addition, the proposed invention relates to a disposable cartridge with the features of paragraph 24 of the claims. It is then provided that the disposable cassette includes at least one hydraulics module, wherein the hydraulics module is implemented with the features of a hydraulics module according to one of claims 1 to 22, and in a preferred embodiment, the blood module is also integrated into the cartridge.

The cartridge is preferably used for use in a unit for carrying out a dialysis treatment process, and in a preferred embodiment, it is a unit for carrying out a dialysis treatment process for a system for providing a dialysis treatment process in accordance with claims 1 to 21 of the claims. In a preferred embodiment, the unit for carrying out the dialysis treatment process is provided with corresponding clamping elements to which or into which the cartridge can be connected via corresponding mating parts.

The hydraulics module, in particular the hydraulics module of the tube set and / or the cartridge hydraulics module, has, in particular, all functions or functional elements for processing dialysis fluid, in particular a balancing unit for balancing fresh and used dialysate, as an option, a heating device for heating fresh dialysate, pressure sensor, temperature sensor, device for detecting blood leaks, as an option a sensor device for determining the coefficient of purification and as an option pump cf dstvo to move dialysate and the ultrafiltrate. The sensor device or other sensors used must not necessarily be components of a hydraulic module, but may, in a preferred embodiment of the invention, be also components of a unit for carrying out a dialysis treatment process. Implemented in a preferred embodiment as a disposable module, the hydraulics module then has corresponding interfaces for connection to sensors or to a sensor device.

The blood module, in particular the blood module of a tube set and / or cassette, in a preferred embodiment has all the functions or functional elements for treating a patient undergoing dialysis treatment, in particular a blood temperature monitor, temperature sensor, sensory technique for analyzing blood composition, for example , for hemoglobin, plasma fraction, blood volume, anticoagulant delivery mechanism, gas bubble formation detector, fluid detector and ultrasonic sensor technology. A sensor device or other used sensors should not be necessarily components of a blood module, but may, in a preferred embodiment, also components of a unit for carrying out a dialysis treatment process. Carried out in a preferred embodiment in the form of a disposable module, the blood module then has corresponding interfaces for connection to sensors or to a sensor device.

In a blood module, in a preferred embodiment, a filter can be integrated to carry out the dialysis treatment process.

The proposed invention further relates to a unit for carrying out a dialysis treatment process in accordance with the features of claim 25 of the claims. Then it is provided that the block for the implementation of the dialysis treatment process is created according to one of claims 1 to 21 of the claims, the block for the implementation of the dialysis treatment process is, in particular, the dialysis apparatus or the monitor of the dialysis treatment process, and in the preferred embodiment, the block for the process dialysis treatment is equipped with a hydraulics module according to claim 22, a disposable tube set according to claim 23 and / or a disposable cartridge according to claim 24.

The invention is illustrated by drawings.

The drawings show:

FIG. 1 is a schematic representation of a conventional dialysis treatment support system; FIG. 2 is a schematic representation of a conventional continuous renal replacement therapy (CECT) system;

FIG. 3 is a schematic illustration of a bedside monitor system;

FIG. 4 is a schematic illustration of an embodiment of a system for providing a dialysis treatment process in accordance with the invention;

FIG. 3 is a schematic illustration of a possible embodiment of FIG. 4 embodiments of the invention;

FIG. 6 is a schematic representation of a further possible embodiment shown in FIG. 4 embodiments of the invention;

FIG. 7 is a schematic representation of a further possible embodiment shown in FIG. 4 embodiments of the invention; and FIG. 8 is a schematic diagram of a further possible embodiment shown in FIG. 4 embodiments of the invention.

FIG. 1, 2 and 3 show in a schematic representation the traditional system for supporting the dialysis treatment process, the traditional system of continuous renal replacement therapy (sopiyoi5 hepa1 ger1acetep1 (Negaru - SECT) and the well-known bedside monitor system. , 120 and 200 are depicted as circular elements.

In the conventional dialysis treatment system 10 according to FIG. 1, a central supply unit 12 and at least one, most often several dialysis apparatuses 20, i.e., dialysis apparatuses 20, are typically provided. Fresh water is usually supplied in a centralized manner by means of a stationary reverse osmosis unit or an ultrapure water unit. In contrast, dialysate preparation, ultrafiltration control and the formation of an extracorporeal circulatory system are decentralized through a separate treatment unit 20, in particular through dialysis apparatus 20.

For this, for example, a dialysate module 22 is provided in the dialysis apparatus, in particular for dialysate preparation, a hydraulic module 24, in particular for ultrafiltration control, and a blood module 26, in particular for forming an extracorporeal circulation system. So, for example, by dialysate module 22, by mixing the concentrate 23 and fresh water supplied, the dialysate necessary for the dialysis apparatus can be prepared.

Moreover, all fluid paths or fluid supply means are provided as reusable means on the dialysate side of the dialysis system 10, that is, in particular, also fluid paths in the dialysate module 22 and in the hydraulic module 24. In accordance with this, regular cleaning, disinfection, and also decalcification is necessary.

The extracorporeal circulation system in the blood module 26 is provided, however, for single use and is implemented, therefore, as a rule, in the form of a disposable system.

As shown in FIG. 2, in the treatment blocks for continuous renal replacement therapy (sopiyoik geia1 ger1asetei1 Legaru - CECT), abbreviated treatment blocks of CECT, there may be no central feeding block 12 in accordance with FIG. 1. Instead, a dialysate container 123 or an infusate container 123 is used. Since these treatment units 120 are used under processing conditions in which the place and frequency of use varies greatly. The main area of their application is, for example, the treatment of acute renal failure in intensive care patients. Their use at the stage of intensive care imposes further high demands on them in relation to hygiene and, thus, the disinfection of such treatment blocks. Therefore, for such treatment blocks 6,026,018, disposable hydraulics modules 124 and disposable blood modules 126 are formed. Thus, it is possible to quickly and reliably equip the treatment units 120 even after a long operating time, since the treatment units 120 lack reusable fluid paths, which therefore must not be cleaned, disinfected or decalcified.

FIG. 3 shows a known bedside system 200 with a central feeding unit 212 and a central dialysate preparation unit 222, in which the concentrate 223 and fresh water are mixed to form a dialysate. The dialysis apparatuses 220, which may be provided in an amount of n, have respectively a hydraulic module 224 and a blood module 226, which can be implemented comparable or structurally similar to those shown in FIG. 1 and described in connection with this module 24 hydraulics and module 26 blood. And in this case, all fluid paths are made in the form of reusable systems on the dialysate supply side of the bedside system 200. Therefore, in this case, in particular, the hydraulic module 226 must be regularly cleaned, disinfected, and decalcified.

FIG. 4 represents, as a first embodiment of the invention, a central dialysis treatment process system 300. Moreover, a central feeding unit 312 and a central dialysate preparation unit 322 are provided in which the concentrate 323 and fresh water are mixed to form a dialysate.

The disposable modules of FIG. 4-8, systems 300 are depicted primarily as circular elements.

A dialysate can be defined in a preferred embodiment as a fluid that has at least 50% of the sodium and bicarbonate content necessary for the dialysis treatment process.

The treatment units implemented in the form of dialysis apparatus 320 are connected to a connecting pipe by means of corresponding connecting elements indicated by arrows 321, through which dialysis apparatus 320 can be supplied with dialysate. The connecting pipe 315 may be, for example, a stationary annular pipe 315.

In a preferred embodiment, all fluid means 324 and 326, that is, a hydraulic module 324 and a blood module 326, which are at least indirectly in contact with the patient or his blood, are disposable, that is, disposable.

The hydraulic module 324 in a preferred embodiment has all the functions or functional elements for treating dialysis fluid, in particular a balancing unit for balancing fresh and used dialysate, optionally a heating device for heating fresh dialysate, a pressure sensor, a temperature sensor, a device for detecting blood leaks , as an option, a sensor device for determining the coefficient of purification and as an option pumping means for moving the dialysate and an ultrafilter ta.

Blood module 326, in a preferred embodiment, has all the functions or functional elements for treating a patient undergoing dialysis blood treatment, in particular a blood temperature monitor, a temperature sensor, a sensor technique for analyzing blood composition, for example for hemoglobin, plasma fraction, blood volume, delivery mechanism anticoagulant, gas bubble detector, fluid detector and ultrasonic sensor technology.

As for the sensor technology and actuating elements, it can be provided for disposable hydraulics modules 324 and blood modules 326 that in this case only elements for connecting to the sensor technology and actuators are disposable.

Modules 324 and 326, in view of the fact that they provide the preparation of various liquid media, can be considered as stand-alone modules 324 and 326. In principle, they can be located, however, on one or several composite blocks. So modules 324 and 326 can be combined into a disposable cartridge. It is also possible to connect modules 324 and 326 into a composite and disposable tube kit including both modules 324 and 326.

The dialyser and the place of infusion of the replacement fluid, not presented in more detail, for hemofiltration therapy or for hemodialysis filtration therapy are, in this case, for example, connecting elements between the modules, to which fluids from both modules 324 and 326 must be supplied.

FIG. 5 shows a variant of the embodiment of FIG. 4 embodiments of a system 300 for providing a dialysis treatment process with dialysis apparatus 320.

In the ring pipe system 315, a valve system is provided including valves U1, U3, and U4, by which dialysate flow can be controlled. In line 315, a reuse or reusable filter P1 is provided as an integrated component of the annular pipe 315, which should preferably be replaced or cleaned only after a certain operating time. Filter P1 separates when

- 7 026018 of this, pipelines 316 and 317 with valves VI and U3 from pipeline 321 with valve U2. Bypass 318 can be bypassed to pipelines 316 and 317, and piping 318 can be closed by valve V4 and usually, first of all, however, it is also closed during the treatment procedure.

Pipelines 316, 317, 318 with valves ν1, ν2, Y3, ν4, as well as with the filter P1 are provided similar and in a preferred embodiment structurally identical for all dialysis machines 320.

Between the hydraulics module 324 and the blood module 326, another disposable and disposable filter P2 is further provided.

The system 300 for providing the dialysis treatment process allows, for example, once a day, preferably at night, to disinfect the ring pipe system 315 without problems.

The first safety stage is formed by the already disposable filter P2. The next safety level is further formed by the filter P1, which after each disinfection process is checked for its functionality.

To carry out the treatment process by means of a dialysis apparatus 320 connected through a pipe 321 to the system 315, the valves ν1 and ν2 are opened to allow dialysate to be supplied to the dialysis apparatus 320. At least one part of this fluid stream or the entire fluid stream can pass through a filter P2 and can be used for priming (rpnnp tobe), flushing (peak Lask), hemodialysis filtration (ΗΌΡ) or hemofiltration (ΗΡ). Part or all of the fluid stream remaining under certain circumstances that has passed through filter P2 can be used as a dialysate.

Valves ν3 and ν4 in the disinfection step can be used to disinfect the annular pipe system 315. They are preferably controlled by a central control unit and adjusting the annular pipe 315. The valve ν2 during the disinfection of the annular pipe system 315 is typically closed.

At least one first filter (P1, P1 ', P1) is provided, located upstream of the hydraulic module (324) and the blood module (326), and at least one second filter (P2) located between the hydraulic module (324) and a blood module (326).

At least one first filter (P1) is reusable and which is located upstream of the dialysate in relation to the hydraulic module (324) and blood module (326).

At least one first filter (P1 ′, P1) is designed as a disposable filter.

At least one second filter (P2) is made in the form of a disposable filter.

At least one second filter (P2) is made in the form of a component of a hydraulic module (324) and / or a blood module (326).

The hydraulic module (324) and the blood module (326) respectively comprise a filter (P1 ', P1, P2), made as an integral part of the hydraulic module (324) and / or module (326). FIG. 6 shows a modification of FIG. 5 embodiment of the invention. Identical elements are provided with identical reference numbers. Presented in FIG. 6 embodiment of the invention allows to produce only one hemodialysis treatment procedure.

In this case, there is no disposable filter P2, which, as shown in FIG. 5, an embodiment is located between the hydraulic module 324 and the blood module 326. Priming can be done in this case also on-line, namely by means of the fact that the filter P1 is used as the first ultrafilter, and then the dialyzer as the next ultrafilter. The dialysate on the dialysate side is passed through the semipermeable dialyser membrane on the blood side, so priming can be performed.

FIG. 7 shows a modification of FIG. 5 and 6 of an embodiment of the invention. Identical elements are provided with identical reference numbers.

In this case, the reusable filter P1 from FIG. 5 and 6 of the exemplary embodiment of the invention are replaced by another disposable filter P1 ′. Thus, in this case, at least two disposable filters P1 'and P2 are provided, which are respectively configured as ultrafilters. These ultrafilters P1 ′ and P2 may be upstream and / or downstream of the hydraulic module 324.

The upper dialysis apparatus 320 shows a first arrangement in which a disposable filter P1 ′ is located upstream of the hydraulic module 324 and a second disposable filter P2 is in the direction of the hydraulic module 324.

The lower dialysis apparatus 320 ′ shows a second arrangement in which both filters P1 and P2 are located along the location of the hydraulic module 324. The disposable filter P1 is thus located along the location of the hydraulic module 324, and the second disposable filter P2 is located opposite the location of the blood module 326.

FIG. 8 shows a modification of FIG. 7 of an embodiment of the invention. Identical elements are provided with identical reference numbers.

In this case, as shown in FIG. 6 of the embodiment of the invention, one of the two ultrafilters is absent, so that only one operation can be performed in the hemodialysis treatment regimen.

Priming can be done in this case also online, namely by the fact that the filter P1 '' 'is used as an ultrafilter, and then the dialyzer is used as the next ultrafilter. The dialysate on the dialysate side is passed through the semipermeable dialyser membrane on the blood side, so priming can be performed.

The upper dialysis apparatus 320 shows a first arrangement in which the disposable filter P1 is positioned against the direction of the hydraulic module 324.

The lower dialysis apparatus 320 ′ shows a second arrangement in which the disposable filter P1 ″ ″ is located along the location of the hydraulic module 324.

FIG. 5-8, thus, demonstrate various arrangement options for filters P1, P1 ', P1, P1' '', P2, which are located between and / or in front of the individual modules 324 and 326 relative to the direction of flow of the fresh dialysis fluid. Under the filters P1 , P1 ', P1, P1' '', P2 refers to ultrafiltration filters that can disinfect the supplied dialysate. Various types of filters are formed for such processes, preferably hollow fiber modules. The average pore size of the filter may be about 0.2 microns.

For hemodialysis filtration treatment, an available substituent, which has the same composition as the dialysate used in hemodialysis, is introduced into the conduction pathways of the extracorporeal circulation system. In a preferred embodiment, drip chambers of the circulatory system are used for such an infusion. Submission of the substituent in the system of blood tubes can be carried out before and / or after the filter. It is possible to make a substituent directly, that is, online, from dialysate through an additional filtering step. This method is used for online hemodialysis filtration (more research), which is possible, for example, by means of those presented in FIG. 5 and 7 systems.

In principle, in addition to this, which is not presented in more detail in FIG. 5-8, dialysis filters or dialyzers can be integrated into blood module 326.

Presented in FIG. 5-8, dialysis apparatus 320 or 320 ′ for discharging used dialysate have outlet pipes 500 that lead either to a central outlet pipe not shown in more detail, or to a collection tank, for example a container for used dialysis solution.

Claims (13)

CLAIM 1. A system for carrying out a dialysis treatment process, comprising a central module for preparing dialysis fluid, a conductive device for transporting dialysis fluid, several units for performing a dialysis procedure, couplers for attaching units for performing a dialysis procedure to the conductive device, a valve system having valves for regulating the flow of dialysis fluid to the blocks for the dialysis procedure, and as the only devices for transporting dialysis the fluid in the blocks for the dialysis procedure provides hydraulic modules made disposable, and for transporting blood to the blocks for the dialysis procedure provided blood modules made disposable, at least one filter having a first region connected to a Central module for preparing dialysis fluid , and a second region connected to at least one of the blocks for the dialysis procedure, with the separation of the first filter region from the second filter region by a membrane, p Moreover, the valve system includes several valves that are controlled by the control unit, while in the first mode, the control unit adjusts the valves to transport fluid from the central module to prepare dialysis fluid through the first and second filter areas to the units for the dialysis procedure, and in the second mode, the control unit sets the valves to transport liquid to at least one of the available first and second filter regions without transporting liquid from the central module for preparing dialysis fluid for the blocks for the dialysis procedure. 2. The system (300) according to claim 1, characterized in that it has filters (P1, P1 ', P1, P1'), and at least one filter (P1, P1 ', P1, P1') to prevent reverse bacterial contamination and / or for filtering dialysis fluid is located upstream of the hydraulic module (324) and blood module (326), and at least one filter (P2) is located between - 9 026018 hydraulics module (324) and blood module (326). 3. The system (300) according to claim 1, characterized in that at least one filter is made in the form of a reusable filter (P1), which is located in the direction of the dialysate flow upstream of the hydraulic module (324) and blood module (326) . 4. The system (300) according to claim 2, characterized in that at least one of the filters (P1, P1 ', P1, P1', P2) is made in the form of a disposable filter. 5. System (300) according to claim 2 or 4, characterized in that at least one of the filters (P1, P1 ', P1, RG) to prevent reverse bacterial contamination and / or filtration of the dialysis fluid is made as a component of the module (324) hydraulics, and the filter (P2) as an integral part of the blood module (326). 6. The system (300) according to one of claims 2 to 5, characterized in that one of the filters (P1, P1 ', P1, P1', P2) is made in the form of an ultrafilter, in particular an ultrafilter in the form of a filter made of hollow fibers, moreover, the filter membrane (P1, P1 ', P1, P1', P2) preferably has an average pore size of about 0.1-0.5 microns, in a particularly preferred embodiment, the average pore size of about 0.2 microns. 7. The system (300) according to one of claims 1 to 6, characterized in that it comprises at least one connecting pipe (315) as connecting devices, by means of which dialysing fluid can be transported and from which at least three a pipeline (316, 317, 318) for a dialysate with a valve system that contains at least three valves (U1, U2, U3), and accordingly one valve (U1, U2, U3) is located in each of the pipelines (316, 317, 318) for the dialysate, through which the dialysate is supplied to the block (320) for conducting Ia dialysis. 8. The system (300) according to claim 7, characterized in that the two pipelines (316, 317) for the dialysate are configured to attach to the first filter chamber (P1), which is located on the first side of the filter (P1) and is separated from the second chamber filter (P1) by means of a filter membrane (P1), wherein the third dialysate conduit (318) is configured to attach to the second filter chamber (P1), is located on the second side of the filter (P1), both of which are first through the next third conduit (318) pipeline (316, 317) can be bypassed or a third pipe rovod (318) forms a bypass conduit (318) to both the first conduit (316, 317). 9. System (300) according to one of claims 7 or 8, characterized in that at least of these three valves (U1, U2, U3) are made of a valve device, and by means of a control unit and / or adjustment, the valve device can be brought activated and / or included to disinfect the filter (P1) on one or both sides and / or through the filter membrane (P1). 10. System (300) according to claim 9, characterized in that by means of a control unit and / or adjustment, the valve device can be actuated and / or turned on in such a way that through the valve device the filter (P1) can be alternately disinfected from both sides of the filter membrane (P1) and a disinfectant liquid can be passed through it. 11. System (300) according to one of claims 9 or 10, characterized in that in the first mode, the first valve (U1) consists of two valves (U1, U3) located in the pipelines (316, 317) for dialysate, which are made with the possibility of attachment or attached on the first side of the filter (P1), is made with the possibility of translation into the open position, while the second valve (U3) of the two valves (U1, U3) is closed or made with the possibility of closing, and the third valve (U4) located in the next third pipeline (318) for dialysate, which is made with the possibility of connection or connected to the second side of the filter (P1), is made to close or close, and in the second mode, the first valve (U1) of two valves (U1, U3) is made to close or close, and the second valve (U3) of two valves (U1, U3) is configured to translate into an open position, and the third valve (U4) is configured to translate into an open position. 12. The system (300) according to one of claims 9 or 10, characterized in that at least one dialysate conduit (315) for transporting the dialysate is provided between the block (320) for carrying out the dialysis procedure and at least one at least one fourth valve to shut off the flow of dialysis fluid. 13. System (300) according to claim 12, characterized in that the fourth valve (U2) is located upstream of the hydraulic module (324) and downstream of the filter (P1) in and / or connected to the second filter side (P1) in the dialysate-conducting conduit (321), the filter (P1) being located between at least two valves (U1, U2, U3, U4) of the valve device, and in the preferred embodiment, two valves (U1, U3) are located on the first side of the filter (P1), and two valves (U2, U4) - on the second side of the filter and (P1).